Dieulafoy's cirsoid aneurysm of the duodenum

Stephen A. McClave, Steve Goldschmid, John T. Cunningham, William P. Boyd

Research output: Contribution to journalArticle

42 Scopus citations

Abstract

Dieulafoy's lesion or cirsoid aneurysm is a rare cause of massive upper gastrointestinal hemorrhage. Historically cirsoid aneurysm most often occurs in the stomach, but has been reported to occur in the jejunum. In this paper, four cases are presented that are felt to represent the first documented cases of cirsoid aneurysm involving the duodenum. At endoscopy, the appearance of Dieulafoy's lesion may range from a pinpoint dot, clot, or tortuous vessel, to blood oozing or spurting from normal mucosa. A shallow defect may be present that can give the appearance of a partially healed peptic ulcer. Previous histologic studies have shown a wide-caliber-persistent artery with intimal thickening, sclerosis, and medial muscular hypertrophy. Once the diagnosis is made, surgical intervention utilizing simple ligation of the involved vessel results in cessation of recurrent hemorrhage. Dieulafoy's lesion is probably more common than the previous literature would suggest. The lesion needs to be considered in the clinical setting of the patient with massive upper gastrointestinal hemorrhage, a paucity of symptoms, and negative findings on barium studies, endoscopy, and exploratory laparotomy.

Original languageEnglish (US)
Pages (from-to)801-805
Number of pages5
JournalDigestive Diseases and Sciences
Volume33
Issue number7
DOIs
StatePublished - Jul 1 1988

Keywords

  • Dieulafoy's lesion
  • cirsoid aneurysm
  • exulceratio simplex

ASJC Scopus subject areas

  • Physiology
  • Gastroenterology

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